DRUG STUDY

DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION

EFFECTS
GENERIC NAME: Increases osmotic pressure of Prevention, treatment of oliguric SIDE EFFECTS: Before:
Mannitol plasma in glomerular filtrate, phase of acute renal failure  Pulmonary congestion  Check B/P, pulse before
inhibiting tubular reabsorption of (before evidence of permanent  Fluid and electrolyte giving medication.
BRAND NAME: water and electrolytes. These renal failure). Reduces increased imbalance  Assess skin turgor, mucous
Renimax actions enhance water flow from ICP due to cerebral edema, spinal  Acidosis membranes, mental status,
various tissues and ultimately cord edema, IOP due to acute  Electrolyte loss muscle strength.
CLASSIFICATION: decrease intracranial and glaucoma. Promotes urinary  Dry mouth  Obtain baseline weight,
Osmotic diuretic intraocular pressures; serum excretion of toxic substances  Thirst chemistry studies.
sodium level rises while potassium (aspirin, bromides, imipramine,  Marked diuresis  Assess I&O.
DOSAGE: and blood urea levels fall. Also barbiturates).
 Urinary retention
200cc IV bolus protects kidneys by preventing
 Edema
toxins from forming and blocking During:
ROUTE: tubules.  Headache
 Blurred vision  Monitor urinary output to
IV ascertain therapeutic
Contraindication response. Monitor serum
FREQUENCY: Contraindications: Dehydration, Adverse Effects electrolytes
q4H intracranial bleeding, severe CNS: dizziness, headache,
 Assess vital signs, skin
pulmonary edema, congestion; seizures turgor, mucous
TIMING: severe renal disease (anuria), CV: chest pain, hypotension, membranes. Weigh daily.
8 AM – 12 NN – 4 PM increasing oliguria, azotemia, hypertension, tachycardia
Signs of hyponatremia and
– 8 PM – 12 MN – 4 AM progressive heart failure. thrombophlebitis
hypokalemia
Cautions: Concurrent nephrotoxic EENT: rhinitis
agents, conditions increasing GI: nausea, vomiting, diarrhea
sensitivity to bronchoconstriction. GU: polyuria, osmotic nephrosis After:
Metabolic: water intoxication,
hypernatremia, hypokalemia Skin:  Expect increased urinary
rash, urticaria Other: chills, fever, frequency/ volume. May
extravasation with edema and cause dry mouth.
tissue necrosis.
 DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
GENERIC NAME: Citicoline consumption Cerebrovascular diseases – SIDE EFFECTS: Before:
Citicholine promotes brain metabolism e.g. from ischaemia due to  Instruct patient to take the
by restoring phospholipid stroke, where Citicoline medication as prescribed.
BRAND NAME: content in the brain and accelerates the recovery of  Body temperature elevation  Citicoline may be taken with or
Cholinerv regulation of neuronal consciousness and overcoming  Restlessness without food. Take it with or
membrane excitability. It motor deficit. Head Trauma of  Headache between meals.
CLASSIFICATION: also influences the varying severity: In a clinical  Nausea and vomiting  The supplement should not be
Nootropics & Neurotronic mitochondria or energy trial, Citicoline accelerated the  Diarrhea taken in the late afternoon or at
Neurotrophic factories of the brain cells recovery from post-traumatic  Low or high blood pressure night because it can cause difficulty
Peripheral Vasodilators and found to improve coma and the recuperation of  Tachycardia sleeping.
Cerebral Activators memory function. After walking ability, achieved During:
 Sleeping troubles or insomnia
several clinical trials, abetter final functional result
 Blurred vision  Monitor for adverse effects; instruct
DOSAGE: Citicoline has been shown and reduced hospital stay. patient to report immediately if
1 gm to raise the amount of he/she develops chest tightness,
acetylcholine in the brain. tingling in mouth and throat,
Adverse Effects
ROUTES: headache, diarrhea and blurring of
IVTT  Cardiac disorders:
Bradycardia, tachycardia. vision

FREQUENCY: Contraindication:  Gastrointestinal disorders: After:

Diarrhea, epigastric  Contact the physician immediately
q8H Hypersensitivity patients with if allergic reaction such as hives,
hypertonic of the discomfort, stomach pain.
General disorders and admin site rash, or itching, swelling in your
TIMING: parasympathetic face or hands, mouth or throat,
8 AM – 4 PM – 12 MN conditions: Fatigue. Skin and
subcutaneous tissue disorders: chest tightness or trouble breathing
Rashes. Vascular disorders: are experienced.
Hypotension.  Citicoline therapy should be started
within 24 hours of a stroke.
 DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
GENERIC NAME: Inhibits calcium transport Chronic stable angina, given Side Effects Before:
Nicardipine into myocardial and alone or with beta-adrenergic  Assess vital signs and cardiovascular
vascular smooth muscle blockers; hypertension, given  Headache status.
BRAND NAME: cells, causing cardiac alone or with other anti-  Upset stomach  Sustained-release capsule taken whole;
Cardepine output and myocardial hypertensive; short- term  Dizziness do not break, chew, crush, or divide.
contractions to decrease. treatment for hypertension  Excessive tiredness  May take without regard to food.
CLASSIFICATION: when oral therapy is not  Flushing
Antianginal, Antihypertensive feasible or desirable.  Numbness During:
 Fast heartbeat  Monitor B/P during and following IV
DOSAGE:
 Muscle cramps infusion.
10mg  Assess for peripheral edema behind
medial malleolus. Assess skin for facial
ROUTE: flushing, dermatitis, rash. Question for asthenia
IVTT Contraindication: (loss of strength, energy), headache.
Adverse Effects:
Contraindications: Advanced  Monitor serum hepatic enzyme results.
FREQUENCY: aortic stenosis.
CNS: asthenia, drowsiness,  Assess EKG, pulse for tachycardia.
OD Cautions: Cardiac, renal, After:
paresthesia
hepatic dysfunction;
CV: hypotension, peripheral  Avoid alcohol, grapefruit juice, limit
TIMING: 4 PM heart failure; hypertrophic
edema, chest pain, increased caffeine.
cardiomyopathy; aortic
angina, palpitations  Inform physician if angina pains not
stenosis; coronary artery
GI: nausea, dypepsia, dry relieved or hypotension occur.
disease.
mouth  Avoid tasks requiring motor skills,
Musculoskeletal: myalgia alertness until response to drug is
established.
 DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
Generic name: Inhibits HMG-CoA Primary prevention of cardiovascular Side Effects: Before:
Atorvastatin reductase, the enzyme that disease in high-risk pts. Reduces risk  Assess baseline lab results: cholesterol,
catalyzes the early step in of stroke and heart attack in pts with Common: Atorvastatin is triglycerides, hepatic function tests.
Brand name: cholesterol synthesis. type 2 diabetes with or without generally well tolerated. Side  Obtain dietary history.
Lipitor Classification: Therapeutic Effect: evidence of heart disease. Reduces effects are usually mild and
Antihyperlipidemic Decreases LDL and VLDL, risk of stroke in pts with or without transient.
plasma triglyceride levels; evidence of heart disease with multiple Frequent (16%): Headache. During:
Dosage: increases HDL risk factors other than diabetes. Occasional (5%–2%): Myalgia,  Monitor for headache.
80mg/tab concentration. Adjunct to diet therapy in management rash, pruritus,  Assess for rash, pruritus, malaise.
of hyperlipidemias (reduces elevations allergy.  Monitor cholesterol, triglyceride lab
Route: in total cholesterol, LDL-C, Rare (less than 2%–1%): values for therapeutic response.
PO apolipoprotein B triglycerides in pts Flatulence, dyspepsia,  Monitor hepatic function tests, CPK.
with primary hypercholesterolemia). depression.
Frequency:
OD (per night) After:
Contraindication: Adverse Effects:  Follow special diet (important part of
Timing: 8 am Active hepatic disease, lactation, treatment).
pregnancy, unexplained elevated Potential for cataracts,
 Periodic lab tests are essential part of
hepatic function test results. photosensitivity, myalgia,
therapy.
Cautions: Anticoagulant therapy; rhabdomyolysis.
 Do not take other medications without
history of hepatic disease; substantial
consulting physician.
alcohol consumption; major surgery;
severe acute infection; trauma;  Report dark urine, muscle fatigue, bone
hypotension; severe metabolic, pain.
endocrine, electrolyte disorders;  Avoid excessive alcohol intake, large
uncontrolled seizures. quantities of grapefruit juice.
 DRUG NAME MECHANISM OF ACTION INDICATION SIDE EFFECTS/ADVERSE NURSING CONSIDERATION
EFFECTS
Generic name: Irreversibly binds to, Erosive esophagitis Side Effects Before:
Pantoprazole inhibits hydrogen caused by gastroesophageal reflux  Rare (less than 2%):  Obtain baseline lab values, including
potassium adenosine disease (GERD); pathologic  Diarrhea, serum creatinine, cholesterol.
Brand name: triphosphate, an enzyme hypersecretory conditions.  headache,
Pantoloc on surface of gastric  dizziness,
parietal cells. Inhibits  pruritus,
Classification: hydrogen ion transport  rash. During:
PHARMACOTHERAPEUTIC: into gastric lumen.  Evaluate for therapeutic response
Benzimidazole. CLINICAL: Therapeutic Effect: (relief of GI symptoms).
Proton pump inhibitor Increases gastric pH,  Question if GI discomfort, nausea
reduces gastric acid occur.
Dosage: production.
40mg Adverse Effects
Contraindication Hyperglycemia occurs rarely. After:
Route: Hypersensitivity to proton pump  PATIENT/FAMILY TEACHING
IVTT inhibitors (e.g., omeprazole).  Report headache, onset of black, tarry
stools, diarrhea.
Frequency:  Avoid alcohol.
OD  Swallow tablets whole
 Do not chew, crush.
Timing:
 Best if given before breakfast.
8 am
 May give without regard to food.
.
NURSING CARE PLAN
 DEFINING NURSING DIAGNOSIS SCIENTIFIC GOAL OF CARE NURSING RATIONALE EVALUATION
CHARACTERISTICS ANALYSIS INTERVENTIONS
SUBJECTIVE Impaired verbal Dysarthria is a motor After 8 hours of INDEPENDENT: After 8 hours of
“Mag lisod ko ug litok communication related speech disorder in nursing intervention nursing
sa mga words.” as to impaired motor which the muscles that the patient will be ● Use one-on-one The nurse enters the intervention the
verbalized by the patient. function of muscles of are used to produce able to: interactions to engage the client’s world in a patient was able
speech secondary to speech are damaged,  the patient will client in nonverbal play. nonthreatening to:
OBJECTIVE cerebrovascular paralyzed, or report improved interaction to form a
- Impaired ability to accident or brain attack. weakened. The person satisfaction trusting relationship. ● Communicate in
speak with dysarthria cannot with ability to words/gestures that
- Incongruence between control their tongue or communicate. ● Recognize subtle Cues are often difficult are understood by
verbal and nonverbal voice box and may slur  The patient will cues indicating the client to recognize (glancing others.
messages words. There are demonstrate is paying attention or out of the corner of the
- Stuttering strategies to improve increased attempting to eye).
- Slurring of speech communication. ability to communicate.
- Word-finding problems understand.
 The patient will ● Describe for the Naming objects and
demonstrate client what is happening, describing actions,
VITAL SIGNS improved ability and put into words what thoughts, and feelings
T – 36.8 °axilla to express self. the client might be helps the client to use
P – 90 bpm  The patient will experiencing. symbolic language.
R – 18 cpm be able to use
BP – 100/80 mmHg alternative ● Assess response Education may provide
O2 – 97% methods of to activity. motivation to increase
communication, activity level even
as indicated. though patient may feel
too weak initially.
● Identify desired Behaviors that are
behaviors and reward rewarded will increase
them in frequency. Desire for
food is a powerful
incentive in modifying
behavior.

● Instruct patient to Helps promote

perform deep breathing relaxation.
exercises.

COLLABORATIVE:
Play is the normal
● Increase verbal medium for learning in a
interaction with parents pt. development.
and siblings by teaching
them how to facilitate
language development.

● Administer oxygen as To provide proper

ordered by the ventilation.
physician.C
 DEFINING NURSING SCIENTIFIC GOAL OF CARE NURSING RATIONALE EVALUATION
CHARACTERISTICS DIAGNOSIS ANALYSIS INTERVENTIONS
Impaired Physical Cerebrovascular SHORT TERM: Independent
SUBJECTIVE: Mobility related to accident (CVA), also After 8 hours of nursing After 8 hours of nursing
Neuromuscular known as stroke, intervention, the patient will: • Assess Identifies strengths and
intervention, the patient
“kapoyan kayo ko involvement: cerebral infarction,  Patient will extent of deficiencies that may
ug lihok,mura weakness, brain attack, is any maintain/increase impairment initially provide information was able to:
gamayng lihok naku paresthesia; functional or structural strength and function and on a regular regarding recovery.  Patient will
kay dali kayo ko flaccid/hypotonic abnormality of the of affected or basis. Classify Assists in choice of maintain/increase
kapoyon unya mura paralysis brain caused by compensatory body according to 0–4 interventions, because strength and function
sakit sakit sad sya (initially); spastic pathological condition part. scale. different techniques are of affected or
gamay” as paralysis. of the cerebral  Patient will maintain used for flaccid and
verbalized by the vessels of the entire spastic paralysis.
compensatory body
optimal position of
patient. cerebrovascular function as . part.
system. It is the evidenced by  Patient will
sudden impairment of absence of • Observe Edematous tissue is demonstrate
cerebral circulation in contractures, foot affected side for more easily traumatized techniques/behaviors
OBJECTIVE : one or more of the drop. color, edema, or and heals more slowly.
that enable
blood vessels  Patient will other signs of
supplying the brain. compromised resumption of
demonstrate
 lack of energy techniques/behaviors circulation. activities.
 restlessness that enable
 Sleepy resumption of
 withdrawn activities.
behavior  Patient will maintain • Change
skin integrity. positions at least Reduces risk of tissue
every 2 hr (supine, injury. Affected side has
side lying) and poorer circulation and
possibly more often reduced sensation and
if placed on affected is more
side.
 During flaccid paralysis,
• Use arm use of sling may reduce
sling when patient is risk of shoulder
in upright position, subluxation and
as indicated. shoulder-hand
syndrome.

Collaborative

• Set goals Promotes sense of

with patient and SO expectation of
for participation in improvement, and
activities and provides some sense of
position changes. control and
independence.

• Assist patient ROM exercise helps in

with exercise and reducing muscle
perform ROM stiffness and spasticity.
exercises for both It can also helps prevent
the affected and contractures.
unaffected sides.
Teach and
encourage patient
to use his
unaffected side to
exercise his
affected side.